Neel K Bhatt1, Andrea M Park2, Muhammad Al-Lozi3, Randal C Paniello2. 1. Department of Otolaryngology - Head and Neck Surgery, Washington University, Saint Louis, MO, USA bhattn@ent.wustl.edu. 2. Department of Otolaryngology - Head and Neck Surgery, Washington University, Saint Louis, MO, USA. 3. Department of Neurology, Washington University, Saint Louis, MO, USA.
Abstract
OBJECTIVE: The compound motor action potential (CMAP) is the summated action potential from multiple muscle fibers activated by a single nerve impulse. The utility of laryngeal muscle CMAP for quantifying innervation following recurrent laryngeal nerve (RLN) injury was investigated. METHOD: In a series of 21 canine hemi-laryngeal preparations, RLNs were exposed and a stimulating electrode placed. Maximum CMAP amplitudes and area under the curve from the thyroarytenoid (TA) muscles were obtained at baseline and at 6 months following injury to the RLN. Injury mechanisms included crush, stretch, cautery, and complete transection with microsuture repair. RESULTS: Prior to injury, baseline CMAP amplitudes and area under the curve were 15.81 mV and 15.49mVms, respectively. Six months following injury, CMAP amplitude and area under curve were 105.1% and 102.1% of baseline for stretch, 98.7% and 112.7% for crush, 93.3% and 114.3% for cautery. The CMAP amplitude and area under the curve in the transection/repair group had a 54.3% and 69.4% recovery, respectively, which were significantly different than baseline (P < .01, P < .05). These values were correlated with vocal fold motion. CONCLUSION: The CMAP is a measure of vocal fold innervation. The technique could be further developed for clinical and experimental applications.
OBJECTIVE: The compound motor action potential (CMAP) is the summated action potential from multiple muscle fibers activated by a single nerve impulse. The utility of laryngeal muscle CMAP for quantifying innervation following recurrent laryngeal nerve (RLN) injury was investigated. METHOD: In a series of 21 canine hemi-laryngeal preparations, RLNs were exposed and a stimulating electrode placed. Maximum CMAP amplitudes and area under the curve from the thyroarytenoid (TA) muscles were obtained at baseline and at 6 months following injury to the RLN. Injury mechanisms included crush, stretch, cautery, and complete transection with microsuture repair. RESULTS: Prior to injury, baseline CMAP amplitudes and area under the curve were 15.81 mV and 15.49mVms, respectively. Six months following injury, CMAP amplitude and area under curve were 105.1% and 102.1% of baseline for stretch, 98.7% and 112.7% for crush, 93.3% and 114.3% for cautery. The CMAP amplitude and area under the curve in the transection/repair group had a 54.3% and 69.4% recovery, respectively, which were significantly different than baseline (P < .01, P < .05). These values were correlated with vocal fold motion. CONCLUSION: The CMAP is a measure of vocal fold innervation. The technique could be further developed for clinical and experimental applications.
Authors: Marta Cercone; Caitlin M Hokanson; Emil Olsen; Norm G Ducharme; Lisa M Mitchell; Richard J Piercy; Jon Cheetham Journal: Sci Rep Date: 2019-02-25 Impact factor: 4.379
Authors: Mohammed Nazmy Hamad; Nickolas Boroda; Diego Barragan Echenique; Raymond A Dieter; Farid M L Amirouche; Mark H Gonzalez; James M Kerns Journal: Front Cell Neurosci Date: 2022-03-30 Impact factor: 5.505